Objective To explore the effect of an agreement prescription Tongnao Decoction on the severity, recurrence rate and mortality of patients with acute cerebral infarction of phlegm and blood stasis blocking collaterals after treatment.Methods A total of 370 patients with acute cerebral infarction of phlegm and blood stasis blocking collaterals were enrolled.On the basis of routine treatment in the guideline for acute cerebral infarction, all patients in the study were divided into the control group and the observation group according to whether they took Tongnao Decoction or not, and followed up for 9 months.There were 197 cases in the control group and 148 cases in the observation group except the lost to follow-up.The results of the scale of NIHSS,mRS,Barthel were used to evaluate the neurological function of the two groups before the treatment, at the time of discharge, 3 months and 9 months of follow-up, and the recurrence rate and mortality were also evaluated.Results Main indexes: The mRS rating in the observation group was significantly better than that in the control group at the time of discharge, 3 months and 9 months of follow-up（P<0.05）.The number of recurrence and death in the observation group was significantly less than that in the control group during their duration of hospital stay and follow-up, with the difference statistically significant（P<0.01）.Secondary observation indexes: The NIHSS in the observation group were significantly better than the control group at the time of discharge, 3 months and 9 months of follow-up（P<0.05）.The Barthel in the observation group was better than that in the control group at the time of discharge, and 3 months of follow-up（P<0.05）.Conclusion Tongnao Decoction has significant effects on improving neurological deficit, enhancing activities of daily living, reducing the degree of illness, and the recurrence rate and mortality of cerebral infarction in patients with acute cerebral infarction.